Fibromyalgia: How Do I Know I Have It?

“I wake up every morning with a stiff, sore lower back. When I
roll over to get out of bed, I feel like a log and almost have to fall
out of bed. When I finally get to my feet, I’m all bent over and can’t
stand upright for what seems like forever! It takes a couple of hours
before it gradually loosens up enough so I don’t have to shuffle with
each step. I was told by a friend that I might have something called
fibromyalgia and should ask my chiropractor. What do you think?”

To answer this inquiry, let’s first define fibromyalgia
(FM) so that we can compare the two properly. FM is a condition that is
diagnosed by eliminating all other possible causes, including
inflammatory joint conditions, by running various blood tests such as an
arthritic profile. This usually includes tests for rheumatoid
arthritis, gout, lupus, and infection. A Lyme disease test is often
included as that condition can often manifest as a chronic back
condition from any cause. There are essentially no blood tests, x-ray or
other imaging tests, or neurological tests that can specifically
diagnose FM. It is when all these tests come back negative that a
diagnosis of FM is entertained. The patient’s history is probably the
most important aspect of the clinical encounter that helps in the
diagnosis of FM. Most of these patients will report that the onset was
gradual, often present for years. There is usually no specific cause
though there are specific conditions (such as irritable bowel syndrome,
trauma, rheumatoid arthritis and others) that can result in “secondary
fibromyalgia,” where the cause is well known. The big differentiating
historical feature is the presence of widespread, whole body pain – NOT
just low back pain, as reported in the first paragraph above. In FM,
there is often pain in the legs, arms, torso, back, and neck and these
people basically, “…hurt all over.” Typically, there is no radiating
pain down the leg or arm that follows a specific nerve pathway and no
exam findings of neurological deficits. Another unique feature of FM
includes sleep dysfunction. In many cases, sleep interruptions occur 2,
3, or more times a night, often with difficulty returning to sleep. The
quality of pain is often described as numbness, tingling, burning, achy,
deep, boring, and most importantly generalized in location (all over
the body). The intensity is usually reported as high (>6/10 pain
scale scores). The past history usually includes multiple visits to many
different types of doctors and many attempts at different medications
is common – most of which do not help significantly.

Even with
these unique historical features that are consistent with the diagnosis
of FM, it is still necessary to “rule out” other conditions by running
tests as previously described. This is especially important when FM is
secondary to other conditions and can get “lost” in the shuffle,
overshadowed by the other condition.

Treatment for FM includes
many of the same methods for treating other musculoskeletal conditions.
Spinal manipulation, soft tissue release techniques (massage therapy,
trigger point therapy, myofascial release), and various forms of
physical therapy (low level laser therapy – LLLT, ultrasound,
interferential electrical current – IFC, and pulsed magnetic therapy can
also improve function, reduce pain, and reduce the need for
medications). Cognitive therapy, addressing psychosocial issues, can
also be very effective. One of the most important treatment approaches
is exercise. This has been consistently described as being an important
form of care for the FM patient. In addition, dietary management using
an anti-inflammatory diet (gluten-free diet) and supplementation (a
multiple vitamin, calcium/magnesium, omega-3 fatty acids, vitamin D, and
CoQ10) can also be very effective.

Members of ChiroTrust® have taken “The ChiroTrust Pledge”: “To the best of my ability, I agree to provide my patients convenient, affordable, and mainstream Chiropractic care. I will not use unnecessary long-term treatment plans and/or therapies.”

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This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.